My uterus is currently about the size of an upside down pear, although, when required, it can expand up to 100 times this size. This little bag of muscles can also hold up to 150 times its own weight and is the only organ that can grow another organ within it; the placenta.
The reason I have become a walking encyclopedia on reproductive organs is that I have spent the past few hours talking to Elise Tobias, hypnobirthing coach and doula (a trained birth companion). During the length of our interview the conversation covers everything from “shy cervixes” to the burgeoning bureaucracy in the NHS. By the end of speaking with her I feel like I have learnt more about giving birth in the past hour and a half than I have my entire life.
“It’s crazy but schools don’t teach children anything about birth,” Tobias explains to me over a zoom call, the same method she has been using to teach her monthly hypnobirthing classes and fulfilling her responsibilities as doula. “Achieving a positive experience in childbirth, which is what I aim for with my clients, is all about education and preparation. When a woman understands what her body is going through, for example why a contraction (Tobias prefers the term “surge”) can cause pressure or discomfort, it allows her to navigate the situation with so much more control.”
She emphasises how important it is for someone to “hold the space” for a woman giving birth.
The way Tobias expresses her extensive knowledge might have you believe she was a trained medical professional. She is quick to explain though that this is not the case. Her sole purpose is to help parents achieve positive births whether it is their first baby or their fifth. She emphasises how important it is for someone to “hold the space” for a woman giving birth, which is how in 2017 her business, Birth Bubble, was born.
And while some might be sceptical of this business concept, it would appear there is a significant need for it. According to The Birth Trauma Association, 30,000 women in the UK experience birth trauma every year (to put it into perspective, 657,076 babies were born in England and Wales in 2018) and as Tobias tells me, this can have serious ramifications long after the baby is born for both the child and the parents.
Tobias was born by emergency c-section so when it came to giving birth to her own daughter almost three years ago she had convinced herself it would be a difficult and painful experience. What complicated matters was her chronic fear of needles which, when pregnant and required to have regular blood tests, caused her great anxiety. In one instance at a hospital appointment, she became so anxious she passed out.
“The nurse I was with said to me, ‘if you can’t handle a blood test, what are you going to be like giving birth?’ It was actually pretty unhelpful advice seeing as giving birth is nothing like having a blood test, but that made something click in my brain and I thought, I have to sort myself out,” she tells me.
It was many hours of reading the idea of formulating her own hypnobirthing course began to percolate.
Sorting herself out consisted of embarking on a personal crusade of knowledge gathering after a colleague mentioned hypnobirthing as a way of calming stress and anxiety during labour. At first Tobias was dubious. “I thought it all sounded a bit flowery,” she admits, but then she bought ‘The Hypnobirthing Book’ by Katharine Graves and her whole perspective changed. So gripped by the topic and its influence on natural and positive birth experiences, she went on to read 15 more books during her pregnancy. It was during these many hours of reading the idea of formulating her own course began to percolate.
Tobias was the first to have a baby out of her group of friends and found herself handing out advice to them as they too entered motherhood. This advice covered the fundamentals of hypnobirthing; self hypnosis, relaxation and breathing techniques. As it became clear that her advice was resulting in positive experiences for others, while still on maternity leave, she enrolled in Katharine Grave’s hypnobirthing teaching course consisting of three intensive days of in-person training.
It was during this time her parents were separating and Tobias found herself reevaluating what she wanted from life. “I felt like my life had been turned upside down. I needed to find an outlet to focus on. And hypnobirthing was such a passion of mine. I just thought right I have to do this now.” She told me her choice to leave her successful TV job at StudioCanal to embark on a totally new career “felt like a now or never decision.”
Drawing on her extensive research, a habit which continues today, Tobias soon created her own “modern, educational and fun” course which focuses on preparing women, and just as importantly their birth partners, with the right tools to navigate birth as naturally and as peacefully as possible. “60 years ago, most women gave birth at home, drawing on the experiences of aunts or mothers to help guide them. It is a recent phenomenon that birth has become so medicalised,” she tells me.
“In the UK 80% of women experience intervention during child birth while the World Health Organisation specifies that for healthy mothers and babies, only 10% should need medical aid.” This causes the ‘cascade of intervention’, Tobias tells me and can lead women to veering far off their original birth plan, causing increased anxiety and slowing down labour. While I knew the cervix opens during labour, I didn’t know it could also close again if the woman does not feel relaxed enough.
She explains that the hormone oxytocin, often referred to as the ‘love hormone’, in fact means ‘quick birth’
One tip to keep things moving that Tobias shares with women who want to have as natural a birth as possible is to have your partner close by. She explains that the hormone oxytocin, often referred to as the ‘love hormone’, in fact means ‘quick birth’ and is released when we are around those we love. If women produce enough it helps encourage the cervix to soften resulting in quicker labour.
“When I gave birth to my daughter, my husband had to be right next to me,” Tobias recalls. “He wasn’t allowed to touch me,” she clarifies, “but he needed to be so close that I could smell him at all times.” She launches at the camera to demonstrate just how close.
“Having a well prepared birth partner is such an important part of the preparation. I always say if I had to choose, I would work with the dad or birth partner beforehand. They are the ones who need to handle all of the logistics; get the bag together, help with massage and positioning, talk with midwives and doctors and ensure their partner is eating and drinking. All a woman should be focused on is her breathing.”
Tobias understands that our perception of birth is often distorted by modern media. She herself has watched over 600 episodes of One Born Every Minute (part of her previous job in TV), but insists that childbirth is “actually really boring” in comparison to dramatised TV shows. In reality, labour can take a long time, but hospital wards, bound by tight guidelines and policies, are geared up to provide a “carousel of care rather than continuity of care”. In Tobias’s opinion, there is an need for hospitals to “get women in and out” rather than ensuring their experience is a positive one.
Having said this, Tobias cites the expansion of birth centres as a positive step the government is taking to ensure women have safe but less medicalised deliveries. The purpose is to create a more home-like setting with dimmed lights and birthing pools. Women only have access to gas and air though and a limited number of pain relief drugs. Tobias clearly believes, when safe to do so, a less medicalised approach is the best one. “You need to have trust in your body and allow it to go with the flow.”
“If you don’t feel safe in your environment, your body will freeze. This is why so many women get to hospital and their labour stops.”
And that brings us to poo, a topic which Tobias spends a lot of time during her course talking about. “If you decide you want a doula, really the question you need to ask yourself is could I shit myself in front of this person,” she smiles sweetly at me. As if on queue, we hear her husband praising their daughter who is on her potty. “She can’t go without feeling comfortable and having privacy,” Elise shares with me. “And that’s a lot like women in labour. If you don’t feel safe in your environment, your body will freeze. This is why so many women get to hospital and their labour stops.”
After establishing a rota of hypnobirthing classes, Tobias qualified as a doula, attending her first birth two weeks later, bringing several years of theory into practice. She has now been present at six births and another three during coronavirus, where she has offered support through zoom or over the phone. When she lists the services she offers to clients, both in groups and privately, I catch a glimpse of the saleswoman from her previous life, one she admits was “a bit soul destroying”.
We end our conversation musing how funny life is, the way it can change so dramatically within such a short space of time. Four years ago, Tobias never would have thought she would have the privilege to guide women through the “most life changing, yet profoundly normal” moment of their lives. It would seem she has found her calling though, as if it were predestined at birth.